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00:30:00

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San Francisco 11, California 7, Us 5, Shelly Davis 3, Sacramento 2, Deborah Benedict 2, Anne Hinton 2, Tom Nolan 1, Johnson 1, Hopper 1, The Nation 1, Ihss 1, City 1, Medicare 1, Cada 1, Mcspadden 1, Donna Willmet 1, Shareen Micspanneden 1, Queues 1, The City 1,
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  SFGTV    [untitled]  

    January 21, 2013
    6:00 - 6:30pm PST  

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their thoughts and experiences about what is challenging about getting services and health care in san francisco. and let me please repeat if you wish to make a comment during the hearing, would you please fill out a card on the front table and pass it up and we'll see that you get a chance to participate. and we'll now have an introduction by daas executive director anne hinton. >> good afternoon, council members. and director johnson. i am actually shareen micspanneden, the assistant executive director of department of aging and adult services. i apologize on believe of anne hinton who really wanted to be here, but was ill all week and wanted to be here with you today. i will do my best to channel her and do as close to a good job as she would have been if
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she were here. you are familiar with the fact that california is moving to a managed care model for health care deliveriy and in san francisco, that means that health care for people on medical, and for people on medical and medicare will be managed care. in san francisco there are two plans that are responsible for providing that health care delivery. one is san francisco health plan and one is anthem bluecross. san francisco health plan is the non-profit provider and anthem bluecross is the for-profit provider. in san francisco we have the two-plan model. for those people who are seniors and people with disabilities on medical only, those people have already moved into managed care and have seen how it works or doesn't work. we have had a lot of challenges
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with that over the past year or two. in the next couple of years, people who are duly eligible, on medical and medicare at the same time will be entering into that systemment on one hand it's kind of scary because we saw to people with disabilities and seniors on medical only moving into the system and it's been confusing. on the other hand it's a great way to look at how we can make it stronger and better for people. so one of the things that we have been doing at the department of aging and adult services, along with department of public health and the health plans is to look at the delivery system and figure out if there is a way that services can be provided in a more
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coordinated way. our long-term care coordinating council. i was thinking of the acronym, sorry. the long-term care coordinating council is providing oversight for this process and we have a group called the long-term call integration design committee, that is overseeing kind of the coordination of services and supports that kind of get attached to health care they are overseeing that process and saying how could we coordinate better all of the services that we provide to seniors and people with disabilities? so we have a really coordinated system when managed care comes about. so the first three services that are going to be part of managed care, at least for the long term is supports and services side are in-home supportive services, the multi-purpose senior services program, which is care
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management. and then the c bass program, which is the new term for adult day health, so the benefit, which stands for community-based adult services and that is an adult day health care. those three will definitely be part of managed care, but we have an opportunity to work with the health plans to say that maybe there are other ways to help people stay in the community safely and happily in their own homes and own communities.on and i have been at four different sites to ask people what are those things that you need to live safely in the community? what are things that are currently not working? what are things that really do work for you or for people that you work with, for people you provide care for? and you know, we really want to just kind of find out what
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those things are. those things will be bampart of this long-term integration plan we're putting together. we're just work right now on getting input from people, getting input from different groups, from the design committee and subcommittees that we have had. we're going put together the plan and we'll be coming back to you with the plan to get some additional feedback from you and get your thoughts on the plan myself. my colleague tom nolan is in the back. you are probably familiar with him from muni, but he works can department of aging and adult services and he will help me take notes. i am here to hear from the council members and members of the public on what you think works? doesn't work? what you would like to see for service and supports for people who live in the community, to remain living in the community.
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>> i have a number of speakers scheduled. we have a good amount of time, but i will limit them to 4 minutes, roughly. and we'll begin. first i have mr. max lane. >> i will be very brief. i think i have come to the wrong agenda item. so the introduction was very helpful. i will stay for the session to hear the information. mine was more of a process comment. i am a san francisco resident for the last 40 years. south of market resident for the last 17 years and have watched steady improvemented in access on the sidewalks. so this was the closest agenda
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item i could find to come in and compliment whoever is doing that process -- taking that process. because i am a full-time wheelchair user and i go everywhere. and south of market is set up so you can go everywhere. i would like to compliment whoever is doing that. i'm sure department of public works is doing that. there are very few problems that i have getting around construction sites and all of those construction sites have ramps to get around them and they are maintained. and the signs are sometimes kind of crude and difficult to read, but there are signs. disabled access this way. so i just wanted to make that comment, so maybe that will get to some of the people that are doing the work, that they are doing a good job and it's accessible for me. and i look forward to hearing the rest of the agenda. thank you. >> thank you.
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next i have mr. bob planthold. >> i'm bob planthold. i think win of the major concerns and needs frankly is simply money. let's face it ihss hours are cutback. adult day health care services are cutback. programs are in peril that affect people. we hear talk there isn't money, but i want to bring to your attention last fall san francisco voters passed a tax-change measure. and the mayoral spokesperson in a later article indicated there likely could be more money from this new local tax measure that
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replaced an outdated one. to the extent that the office of disability, department of aging and adult services and mod can monitor the income from this new tax, i'm going to suggest that some of that extra money could be devoted to restoring some level of the cutbacks already made locally. but statewide is the larger issue. that is where the major changes have come. so i also wanted to alert you to a program called "a california budget for all of us." it's convening groups include well-known groups like the western center on law and poverty, health access, the california partnership, and the california immigrant policy center. the mantra is "restore, rebuild and reinvest." so this advocacy will be taken up by various groups including the california alliance of retired americans.
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there are four polices that are coming from this california budget for all of us. four polices for the coming california budget cycle. one, restore the social safety net cuts being implemented now during this 2012-2013 fiscal year. second, a moratorium on cuts to vital programs for vulnerable californians in the coming year. that includes lots of us. third, continue to work for revenue solutions to close budget gaps in future budgets. fourth, corporations must pay their fair share, too. i will give a copy of this to miss mcspadden, so she can follow-up. i want you folks to be away there are lobby days set for later in may for the governor's revised budget, both for seniors and also for those with
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disabilities. i encourage you to monitor and track those, so you can also go and make your voices heard. on a separate note, there is another aspects i think have been overlooked. various groups have developed or developing lawsuits to try to stop some of these various cuts. to the extent that city agencis can monitor these lawsuits to push support of these lawsuits to stop some of these cuts if the voice of san francisco is it put into the hopper, it may also encourage other cities and counties to do the same. and you might actually get somewhere, even though we don't provide all the same -- i will say campaign contribution benefits that people in sacramento are often accustomed to. thank you. >> thank you, sir. next i have miss deborah
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benedict. : >> hi. deborah benedict, again with senior and disability action and i will also mention that i am a member of californians for disability rights, which is a statewide organization that does keep track of the lawsuits and actions that are going on statewide. so it might behoove the mayor's office on disability to join the californians for disability rights, because there are plenty of emails that i get blasted about that kind of information. one of the things that i wanted to share about my experience of being in managed care at this point was my managed care provider, which is lion martin health care, claimed that they were trying to improve patient experience and they cut out the
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ability to make appointments on a voicemail or that was connected to the company. so now you get put into a phone queue. and i don't know how many people are familiar with being endlessly in loops of phone queues, but it's extremely frustrating when you are sick or need to make an appointment. so that improvement or their efforts to try to improve the patient experience has not in my experience been an improvement. and what would be an improvement, in my opinion, would be the ability to communicate with them in writing through email. and that actually would require accessible, inexpensive or free internet services available to my building and to the other people who are also low-income. you know, the irony of being in
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a community where tech is absolutely key, and all the developments of, you know, the nation and the world are being born here, there aren't technology companies willing to give us free access to internet service is, in my opinion, really almost criminal. because do you think twitter could put out a free wi-fi signal for south of market or for the tenderloin or for place where's there is a lot of low-income people who use services? who could make appointments online and search for health information? so in many opinion. that one thing of getting internet service into low-income communities, where you could get certainly used computers, very inexpensively. i have an older computer, but it's connected to the internet.
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and quite frankly, right now, i can't afford on my income to have regular internet service. so it requires me draging it to a cafe or somewhere, which does have internet service. why can't the mayor, who is going around to each one of these internet service companies why can't they get together and provide us in the low-income neighborhoods, which they are getting huge tax breaks on, internet service? that would be a huge benefit to me and i'm sure it would be a huge benefit to a lot of other people as well. if anything, please press the ear of the mayor, who is out glad-handing every tech company there is to please ask them to contribute to a pot to help the people in the neighborhood that they are getting the big tax breaks from. >> thank you.
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next i have amber depietsa. >> i'm speaking into that? does that pick up my voice? oh, that was simple. thank you. can everyone hear me okay? >> yes. >> okay. i apologize. i have allergies and i'm also low-vision, so reading my notes and sniffling will be part of this process. my name is amber diepetra and speaking as alliance of
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advocates a multi-agency collaborative committee including the mayor's office on disability, ihss, and many other agencies that work on issues common to everyone in the disability community. and specifically i work as a nursing home resource counselor, as part of the independent living resource center. we go into nursing homes and try to provide resources and peer counseling. these are folks who have been isolated from living in communities for a variety of reasons. lack of access to affordable, accessible housing it doesn't exist, or there is not enough people to go around to help disseminate the housing information to folks in these nursing homes, who don't have
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access to those applications. they are not able to leave the nursing homes. i should double-back and say when i'm talking about nursing homes or skilled nursing facilities, a lot of these folks are adults with disabilities. they are not seniors. i have client who are in their 20s, 30s, 40s, 50s and the only reason they are living in nursing homes because there is a lack of services to put a plan together for them to leave. on that note, the staff that work in these nursing homes, however well-intentioned are poorly-trained. they have little knowledge of daas and the services that are offered. so it seems like the folks with disabilities could only benefit if the staff at the nursing homes were to work with daas and collaborate more closely or if daas it h a team that went into the nursing
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homes and provides the folks there with resources. in terms of how they can make a plan to transition out of the nursing home. let's see, there is more i wanted to say. it takes me a moment to read the notes. i guess that is the major point about these young folks who are stuck in nursing homes around the city. completely, stripped of their independence, institutionalized basically pause of a lack of services. not only should i say there is not only a lack of internet access, but a lack of phone. i have a difficult time getting in touch with most of my client because the only phone they can
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use is the phone for 20 people on a ward. so it's hard for them to reach out and find the information. and then i just wanted to mention in terms of folks who are already living in the community, but are on the border of a crisis. they need intensive case management, they need services and help from daas right away or else they are going to go into skilled nursing facilities, which will end up costing the city a lot more money than to keep them at home. so these folks need help from daas in terms of timely response and unfortunately i think the wait list for services causes the folks who are really at this critical edge to be institutionalized. >> thank you. next we have joanna chandler. >> good afternoon. thank you for giving me a venue to ask my questions. i am a disabled turned 626789
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i don't have any idea where to go to get information on how to get into senior services. or if there are any apartments available. for necessity who lives in a beautiful neighborhood, in a beautiful apartment and has a land lady that would give anything not to have me there. it's a very difficult situation for many seniors who are long-term tenants. any time i go to get information they say well, go talk to your social worker. i am not homeless. i don't have a social worker. i don't have a clue how to get a social worker. so i wanted to say i wish there was an easier way of knowing how to get access to information on senior housing that is available. i have called many places and they say, our waiting list is closed. we don't have any idea when it will open up. i mean, the reality is maybe i
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will have to leave san francisco, which is my home, which saddens me. but i just wish there was a way to know. because people seem to know -- there are people that seem to know how to get in and do it and i just don't. and i would like to make that more easy and accessible to more people in my situation. thank you. >> thank you. next is it steve crabiel. >> i'm with tool works a human service agency that provides services to more than 500 adults with disabilities throughout the bay area. we provide vocation and community living services. we are a member of the community alliance of disability advocates known as
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cada. what is not working? housing is not working. we need more accessible affordable housing for the folks that we serve and frankly for our staff. we also need affordable/accessible housing for community-based organizations like tool works. so the price of staying in the city is getting too difficult. and we need to be able to, as an organization to be able to stay here, so we can maintain the social safety net for people with disabilities. what is working? supportive living services are really working for individuals who are eligible for regional center funding. so these are services that allow people to live independently in the communities of their choice, with supports. and and primarily for people with
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developmental disabilities. so that is great, but what is not working are the same services, those community living services for people who are not eligible for that funding. there is a lack of coordination between agencies and organizations. it's particularly around people who are transitioning from institutions, hospitals, people who want to live in the community who can't live in the community without the proper supports. so that is all i have got to say. >> thank you. next is shelly davis. >> hi. okay.
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my name is shelly davis. sorry. is this good? >> yes. >> hi. my name is shelly davis. i am a 20-year-old college student. i am particularly commenting on the lack of programs for younger people with disabilities, particularly for getting help with programs such as ssi and housing assistance. the reason is that you often get shuffled around. there is no definitive counseling that tells you to do any one particular thing. so counseling options for younger people would be great. and for getting ssi, i think there should be a local financial assistance while you are waiting for your ssi,
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because there are financial hardships. and that is really concerning. and basically, in conclusion, i think that the programs right now, they don't facilitate independence as mentioned earlier. the programs, they don't facilitate good transition. so i think that if there are better connections and more programs specifically for youth with disabilities, that we can become more productive members of society. thank you. >> thank you very much. next i have donna willmett.
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hi donna. > >> good afternoon council members. my name is donna willmet and i'm from senior and disability action, where i am a staff member, who works as a consumer advocate. and i just want to begin my remarks with the acknowledgment that san francisco largely because of the leadership of the department of aging and adult services provides. we are a resource-rich city in many ways. so i'm not going to take up all my time talking about the things that are working, but i will try to address a couple of things that i think we could turn our attention to. the first is medical share of cost; which i think is a huge issue for many people, people who are not eligible for medicare, but are trying to access medical to help pay for things like ihss and other medical needs. and if you are caught in the
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upper poor strata, for instance, the way the shared cost works and probably many of you know this already. say you make $11 only $1100 a month, which is not very much in the cost. the medical whatever your medical expenses are you have to pay the difference between $1100 and $600. this is really prohibitive and we need to figure out as a city how to address the share of cost issue. because it has a huge impact on the quality of life for a lot
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of people. the other thing that i would like to speak to for just a minute -- this originates in sacramento, but the fact that the medical budget cuts meant that people no longer get dental care, incontinence supplies is not paid for. this is creating a horrible situation for a lot of people that cannot afford dental care. there is very few avenue to get anything done besides getting a tooth pulled on an emergency basis. so those are quality of life issues. the last thing i would like to speak to is just asking us to address the question of who gets left out of the information loop? i was struck by some of the recent community meetings that were sponsored around the changes

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